Description of Concrete Experience: I chose to have gastric bypass surgery because I was dealing with high blood pressure, high cholesterol, and diabetes due to my weight. Over time, my weight had just continued to creep up until it reached a point that made it really dangerous for me. Additionally, back pain, knee pain, and joint pain were always present, and it hurt to walk and move around, so daily life activities were difficult to handle. I got out of breath when walking even short distances, and with that and the joint pain, exercising to lose weight was really not possible for me anymore. Even though I used to exercise, it was not something I could go back to until some of the weight was gone and the stress on my joints was lessened. My primary care doctor told me I would be dead within 10 years if I did not lose weight, so I saw gastric bypass as my only option for potential success. Diets and other methods in the past had not been successful.

Reflections: Looking back on my life, I realize that I was not careful with the way I ate. Eating became a pleasure and a crutch, instead of something that was used for fuel for my body. When I finally came to terms with the way I was eating and how much weight I had gained, I knew it was time to make a change. By that point, though, I was too heavy to get much exercise and the patterns I had gotten into were a big part of my life. Because of that, it was very difficult for me to make the kinds of changes I knew in my heart I should make. That was why I decided to have the surgery, because I knew without it I would only continue to get larger and may not live to see my children grow up.

Generalizations/Principles/Theories: There are several theories about excess body weight and the health consequences that come with it. Numerous studies have shown that people who weigh more have a higher chance of having problems like high blood pressure and high cholesterol. They can also have joint problems, heart disease, diabetes, and a host of other ailments that come along with their extra weight. Of course, not every person who is larger or heavier will have these health conditions, and some people who are heavy can also be relatively healthy. It often depends on their genetics, but also on how well they carry their weight in the sense of how well they can exercise and move around with the weight they have. People who are able to exercise and who stay active are generally healthier than those who are sedentary regardless of their weight, but that is not always the case.

Testing and Application: I tested the idea of needing gastric bypass to lose weight by attempting a number of things first. I tried to exercise but was not successful with it, and I also tried to diet -- but nothing kept the weight off. Usually, I would lose a few pounds, but then I would either stop doing the diet or I would find that I just did not lose any more weight. Once I hit a plateau, I really was not interested in working any harder to lose weight, or was not able to lose more weight because I could not get the exercise I needed to do so. I know that diet and exercise are both important to losing weight and staying healthy, but putting that into practice is not always easy.

Current Nutritional Theories and Recommendations for Maintaining Healthy Weight

Description of Concrete Experience: Gastric bypass is a type of last-ditch effort when it comes to losing weight. It is usually performed on people who have done a number of other things to lose weight and who have not been successful in anything else they have tried. For me, that was very accurate. I had been through other types of nutritional programs and had been given many recommendations as to what I should do in order to lose weight and maintain a healthy weight once I reached it. Despite that, I avoided doing what I should do and stated that it was too difficult. There was always some excuse or reason why I was not able to make my experience match up with what I knew I "should" be doing based on nutritional recommendations and guidelines, and I began to feel like a failure. Many of the recommendations and theories are also for people who are at a lower level of obesity than I had reached, so they are able to exercise more and help maintain proper weight. Once I reached a certain point in my weight gain, I was no longer able to exercise enough for it to have any benefit for me, so I gave up on it.

Reflections: I think the giving up on exercise and proper nutrition was a real turning point for me. It was as though I simply accepted my overweight status, and decided that there was nothing I could do about it. By doing that I ended up gaining even more weight, instead of only maintaining the weight I already had. It is much harder to follow a plan for diet and weight loss than many people think, and when you have a lot of weight to lose it can become even more difficult because it seems as though you can never really lose the weight. It takes too long, and that kept me from really working at it. I wanted to see quick results, so I would believe I could really lose the weight and be thinner (or at least average weight) again. When I did not lose weight rapidly, I stopped trying. That made it very difficult for me to continue to focus on weight loss.

Generalizations/Principles/Theories: Nutritional theories and principles are important, but they do not work for everyone. Often, this is because each person is a unique individual and may lose weight more or less easily than another person even if they are trying the same program. While nutritionists are firm believers in what they are doing and the information they are offering to people who need to lose weight and/or eat healthier, they have to understand that each person handles weight loss and health differently. By being aware of that, they can actually help more people because they will be tailoring what they are offering to each person instead of asking people to fit into a mold. When a nutritionist advises a person how to lose weight, he or she is not generally focused on the individuality of that person to any large degree. There are some questions based on a person's lifestyle and other factors, but most of the advice given is the same advice that would be provided to everyone. As such, it is really not as valuable as it could be when it comes to helping a person lose weight.

Testing and Application: Information about nutrition and weight loss theories can be applied in many different ways. One of the best ways to test these kinds of theories is to offer them to a group of people and see if they work for each person equally. For me, the testing of nutritional theories came from talking to nutritionists and attempting to do what they asked of me based on proper eating habits. However, it was difficult for me to follow some of their advice, and I often felt deprived of the foods I really enjoyed. An "everything in moderation" approach was not acceptable to them, and I felt that I would have done better if that approach had been one that I was able to use. Still, past experimentation has shown me that I am not very good at moderation. If I had been better at moderating what I ate -- and how much of it -- I may have avoided my weight problem.

Psychosocial Principles in Weight Management

Description of Concrete Experience: I was required to have three visits with a weight management psychologist. This was done to make sure of my reasons for wanting surgery, and to help determine if I really did need the surgery or if there were other options that would have been better for me. Additionally, these visits were to assess my state of mind when it came to my dedication to the surgery and the way I would have to live my life beyond that point. It is a very serious lifestyle change, and I could not just have surgery and that would fix all of my problems. It is a true lifestyle change, and one for which I had to be ready of the psychologist would not approve me. During those visits I was asked about the proper kinds…[continue]

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